Sebelius open to 'uniquely Texan' health care plan

CHRIS TOMLINSON | Associated Press

Published 10:37 am, Thursday, August 8, 2013

The Obama administration is open to talks with Texas about expanded health care for the poor, Health and Human Services Secretary Kathleen Sebelius said Thursday, though the state's top Republicans adamantly refuse to cooperate.

Following a meeting with Austin Mayor Lee Leffingwell and other Central Texas officials, Sebelius said her office is open to crafting a uniquely Texan plan to make sure everyone has health insurance. She was in Austin and San Antonio to talk about how local communities can take advantage of the Affordable Care Act.

Texas has the nation's highest rate of people without health insurance — about 6.1 million people — most of them the working poor and single adults. Texas has the option of expanding Medicaid to include those who cannot afford health insurance, but Gov. Rick Perry has rejected all portions of act and wants Washington to hand over the money with no strings attached do Texas can operate its own program.

"We are eager to have discussions with Texas about a program that could look uniquely Texan, we have a number of state governors and legislators who have fashioned programs around Medicaid expansion that have a lot of flexibility," Sebelius said. But she said no talks were under way with Texas officials.

Perry and other Republicans leaders say the health care law infringes on personal liberty and violates state sovereignty. Perry has pledged that state government will do nothing to help implement the program, unless specifically required to by law.

The fact that the nation's second most-populous state is not cooperating represents serious challenges to the Department of Health and Human Services. Sebelius' visit is aimed at encouraging sympathetic local leaders to help implement the program even if state officials won't.

The act requires state-based health insurance exchanges, modeled on travel web sites, where people can compare and enroll in insurance plans as required in 2014. Since Texas refuses to set up its own exchange, the federal government will step in. Because state officials are not promoting the sites so people will participate, Sebelius needs local officials and insurance companies to do so.

Sebelius and local officials also want to draw attention to the repercussions of Perry refusing the expand Medicaid, the health insurance program for the poor and disabled. Federal officials offered to pick up 100 percent of the programs cost in the first two years, if states agreed to expand the program to include the working poor who do not get insurance at work. Currently, only the poorest parents and most severely disabled qualify.

Most of these working poor, single adults rely on emergency rooms for their health needs and local taxpayers pick up the tab when they can't pay. Supporters of the act say that it would be cheaper for taxpayers if these people were enrolled in Medicaid and received routine, preventive health care and stayed out of the hospital.

Perry, though, said in a statement that federal programs were the problem.

"We've been fighting Obamacare from the beginning, refusing to expand a broken Medicaid system and declining to set up a state health insurance exchange," Perry said. "We took these steps to minimize the damage Obamacare will cause to our economy and state budget, although we're all too aware Obamacare will still cause our state immense budgetary challenges in the years ahead."